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Journal of Family Medicine and Primary... May 2024Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to...
Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition because in the early stages, it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.
PubMed: 38948565
DOI: 10.4103/jfmpc.jfmpc_518_24 -
Cityscape (Washington, D.C.) 2024For more than a decade, the U.S. Department of Housing and Urban Development (HUD) and the National Center for Health Statistics (NCHS) have partnered to link NCHS...
The Health Status of Women with Children Living in Public and Assisted Housing: Linkage of the National Health Interview Survey to U.S. Department of Housing and Urban Development Administrative Data.
For more than a decade, the U.S. Department of Housing and Urban Development (HUD) and the National Center for Health Statistics (NCHS) have partnered to link NCHS national health survey data with HUD administrative records on persons participating in federal public and assisted housing programs. This study used 2015-18 National Health Interview Survey (NHIS)-HUD linked data to examine women 18-44 years old with children and renting their home who were receiving HUD assistance (n=852) and a comparison population of women of the same age with children, who were low-income renters but did not link to HUD records at the time of their NHIS interview (n=894). The population of HUD-assisted women differed from the comparison group on key sociodemographic characteristics and health indicators. HUD-assisted women were more likely to report their health as fair or poor and to being a current smoker. HUD-assisted women also were less likely to be uninsured and more likely to have a regular source of care. The findings in this article are exploratory but demonstrate how the NCHS-HUD-linked data can be a resource for researchers and policymakers in further examining housing status as an important social determinant of health.
PubMed: 38948509
DOI: No ID Found -
Sexuality and Disability Dec 2023Participation in sexual medicine research may depend on a patient's willingness to speak openly about sex, sexual function, or other sensitive topics. These topics may...
Participation in sexual medicine research may depend on a patient's willingness to speak openly about sex, sexual function, or other sensitive topics. These topics may be difficult or uncomfortable to talk about, and this discomfort may be further amplified when a patient comes from a cultural background that stigmatizes open conversation about sex and sexuality. We used qualitative analysis to better understand the intersection between cultural identity, the experience of sexual dysfunction as a side-effect of pelvic radiotherapy, and willingness to communicate about sexual dysfunction with healthcare providers, in Cuban American women in Miami, Florida. Doing so, we found four unique themes among Cuban American participants regarding the intersection of national identity, Hispanic identity, Catholic religion, and their experience of radiotherapy-related sexual dysfunction: , and . These themes, a reflection of the cohort's shared identity, were found to have an effect on participant views of sexual health, romantic relationships, coping strategies, and relative comfort discussing problems with intercourse. These cultural values served as barriers to openly discussing sexual dysfunction with not just medical providers and research teams but also their partners, families, and friends. In order to encourage Cuban American participation in sexual medicine studies, future research should evaluate strategies to overcome these barriers.
PubMed: 38948491
DOI: 10.1007/s11195-023-09812-z -
Drug and Alcohol Dependence Reports Jun 2024As the US opioid-involved morbidity and mortality increase, uptake and implementation of evidence-based interventions remain key policy responses. Respond to Prevent was...
Policies, adaptations, and ongoing challenges to naloxone, buprenorphine and nonprescription syringe access across four-states: Findings from an environmental scan and key informant interviews.
BACKGROUND
As the US opioid-involved morbidity and mortality increase, uptake and implementation of evidence-based interventions remain key policy responses. Respond to Prevent was a multi-component, randomized trial implemented in four states and two large pharmacy chains with the aim of improving the pharmacy's capacity to provide naloxone, dispense buprenorphine, and sell nonprescription syringes (NPS). We sought to provide context and assess how policies and organizational practices affect communities and pharmacies across the study states.
METHODS
Using a multi-method approach we: 1) conducted an environmental scan of published literature and online materials spanning January 2015 to June 2021, 2) created timelines of key events pertaining to those policies and practices and 3) conducted semi-structured interviews with stakeholders (key informants) at the state and local levels (N=36) to provide further context for the policies and practices we discovered.
RESULTS
Key informants discussed state policies, pharmacy policies and local practices that facilitated access to naloxone, buprenorphine and NPSs. Interviewees from all states spoke about the impact of naloxone standing orders, active partnerships with community-based harm reduction organizations, and some federal and state policies like Medicaid coverage for naloxone and buprenorphine, and buprenorphine telehealth permissions as key facilitators. They also discussed patient stigma, access in rural settings, and high cost of medications as barriers.
CONCLUSION
Findings underscore the important role harm reduction-related policies play in boosting and institutionalizing interventions in communities and pharmacies while also identifying structural barriers where more focused state and local attention is needed.
PubMed: 38948428
DOI: 10.1016/j.dadr.2024.100243 -
Data in Brief Aug 2024This article presents data collected through Computer-Assisted Web Interviewing (CAWI), conducted in Italy with the aim of exploring the Italian population's reaction to...
This article presents data collected through Computer-Assisted Web Interviewing (CAWI), conducted in Italy with the aim of exploring the Italian population's reaction to the Russian invasion of Ukraine in February 2022 and monitoring this reaction for the first six months of the attack through a six-round survey. Each round involved a representative sample of approximately 1010 (1007-1015) Italian adult citizens. Participants were asked questions about emotional reactions to the Russian invasion, coping strategies used, solidarity behaviour toward Ukrainian refugees, perceptions of refugees as a threat to the country, trust in national and international authorities to manage the international situation, and prospects for the future. Demographic data on the respondents were also collected. The survey design was developed by a research group from two universities (the University of Salento and the University of Foggia) and a European research centre, EICAP (European Institute of Cultural Analysis for Policy). The data provided in this article is a resource for researchers, public authorities, and other parties interested in surveying and studying public opinion. This dataset can be used to explore a wide range of topics, including prosocial behaviour and attitudes towards refugees in humanitarian emergencies.
PubMed: 38948411
DOI: 10.1016/j.dib.2024.110579 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... May 2024To investigate the effect of empathy on depressive symptoms in adolescents and to explore the potential mediating role of family functioning in the effect of empathy on...
OBJECTIVE
To investigate the effect of empathy on depressive symptoms in adolescents and to explore the potential mediating role of family functioning in the effect of empathy on depressive symptoms.
METHODS
The 2022 cross-sectional data from the Chengdu Positive Child Development (CPCD) cohort were analyzed in the study. A survey was conducted in Chengdu in June 2022, involving 3020 students in grades 5-8 from three randomly selected stratified schools. The Interpersonal Reactivity Index (IRI-C), the Chinese Family Assessment Instrument (C-FAI), and the Center for Epidemiologic Studies Depression Scale for Children (CES-DC) were used in the survey. Chi-square test or one-way analysis of variance was performed to examine the differences in various demographic characteristics (sex, grade, region, and total monthly household income) between groups of respondents, as well as the differences in family functioning, empathy, and depression. Pearson correlation coefficient was used to examine the correlation between family functioning, empathy, and depressive symptoms. Structural equation modeling and SPSS PROCESS component Model 4 were used to analyze whether family functioning played a mediating role in the effect of empathy on depressive symptoms in adolescents.
RESULTS
The detection rate of depressive symptoms among survey respondents was 25.40%. The results of the difference analysis revealed significant differences in the detection rates of depressive symptoms among respondents of different grades, regions, and monthly household incomes (<0.05). There was no significant difference in the detection rates of depressive symptoms between male and female students. There was a significant difference in the detection rate of depressive symptoms between respondents with different scores for family dysfunction and empathy ability (<0.001). Correlation analysis results showed that empathy scores were negatively correlated with depression (=-0.11, <0.001), that family dysfunction was positively correlated with depression (=0.29, <0.001), and that empathy scores were negatively correlated with family functioning (=-0.37, <0.001). The mediating role of family dysfunction in the relationship between empathy and depressive symptoms was established, with the direct effect being 0.039 (95% confidence interval [CI]: 0.010-0.069, <0.001) and the indirect effect value being -0.096 (95% CI: -0.115--0.079, <0.001). The direct effect value accounted for 28.89% of the total effect value, while the mediation effect value accounted for 71.11% of the total effect value.
CONCLUSION
The empathy ability of adolescents is correlated to depressive symptoms, and family functioning plays a mediating role between empathy and depressive symptoms in adolescents. It is suggested that adolescents' empathy ability and family functioning should be enhanced through multiple channels to reduce the occurrence of depressive symptoms.
Topics: Humans; Empathy; Adolescent; Depression; Male; Female; Cross-Sectional Studies; Surveys and Questionnaires; Family Relations; Students; China; Family
PubMed: 38948264
DOI: 10.12182/20240560602 -
Human Reproduction Open 2024Are women's reproductive factors associated with physical frailty and comprehensive frailty in middle-age and later life?
STUDY QUESTION
Are women's reproductive factors associated with physical frailty and comprehensive frailty in middle-age and later life?
SUMMARY ANSWER
Early menarche at <13 years, age at menopause <45 years, surgical menopause, experiencing miscarriage and a shorter reproductive period of <35 years were associated with increased odds of frailty, while having two or three children was related to decreased likelihood of frailty.
WHAT IS KNOWN ALREADY
Evidence has shown that women are frailer than men in all age groups and across different populations, although women have longer lifespans. Female-specific reproductive factors may be related to risk of frailty in women.
STUDY DESIGN SIZE DURATION
A population-based cross-sectional study involved 189 898 women from the UK Biobank.
PARTICIPANTS/MATERIALS SETTING METHODS
Frailty phenotype and frailty index were used to assess physical frailty and comprehensive frailty (assessed using 38 health indicators for physical and mental wellbeing), respectively. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% CI between reproductive factors and likelihood of physical frailty and comprehensive frailty. Restricted cubic spline models were used to test the non-linear associations between them. In addition, we examined the combined effect of categorized age at menopause and menopause hormone therapy (MHT) on frailty.
MAIN RESULTS AND THE ROLE OF CHANCE
There was a J-shape relationship between age at menarche, reproductive period, and frailty; age at menarche <13 years and >16 years, and reproductive period <35 years or >40 years were all associated with increased odds of frailty. There was a negative linear relationship between menopausal age (either natural or surgical) and odds of frailty. Surgical menopause was associated with 30% higher odds of physical frailty (1.34, 1.27-1.43) and 30% higher odds of comprehensive frailty (1.30, 1.25-1.35). Having two or three children was linked to the lowest likelihood of physical frailty (0.48, 0.38-0.59) and comprehensive frailty (0.72, 0.64-0.81). Experiencing a miscarriage increased the odds of frailty. MHT use was linked to increased odds of physical frailty in women with normal age at natural menopause (after 45 years), while no elevated likelihood was observed in women with early natural menopause taking MHT.
LIMITATIONS REASONS FOR CAUTION
The reproductive factors were self-reported and the data might be subject to recall bias. We lacked information on the types and initiation time of MHT, could not identify infertile women who later became pregnant, and the number of infertile women may be underestimated. Individuals participating in the UK Biobank are not representative of the general UK population, limiting the generalization of our findings.
WIDER IMPLICATION OF THE FINDINGS
The reproductive factors experienced by women throughout their life course can potentially predict frailty in middle and old age. Identifying these reproductive factors as potential predictors of frailty can inform healthcare providers and policymakers about the importance of considering a woman's reproductive history when assessing their risk for frailty.
STUDY FUNDING/COMPETING INTERESTS
This work was supported by the National Key Research and Development Program of China (2022YFC2703800), National Natural Science Foundation of China (82273702), Science Fund Program for Excellent Young Scholars of Shandong Province (Overseas) (2022HWYQ-030), Taishan Scholars Project Special Fund (No. tsqnz20221103), and the Qilu Young Scholar (Tier-1) Program (202099000066). All authors have no conflicts of interest to declare.
TRIAL REGISTRATION NUMBER
N/A.
PubMed: 38948112
DOI: 10.1093/hropen/hoae038 -
Current Developments in Nutrition Jun 2024Urbanization influences food systems and food security, but research on these associations in low- and middle-income countries remain limited, partly because of the...
BACKGROUND
Urbanization influences food systems and food security, but research on these associations in low- and middle-income countries remain limited, partly because of the binary and unstandardized "urban compared with rural" classifications.
OBJECTIVES
To develop a community urbanicity scale, to assess its associations with household food security, and to explore whether agricultural occupation modifies this relationship across the 3 agroecological zones (mountain, hill, ) of Nepal.
METHODS
Data came from a nationally and agroecologically representative, multistaged 2013 agri-food system survey of 4285 households with children <5 y in 63 communities (wards) in Nepal. A novel community-level urbanicity scale was constructed using factor analysis that included 8 domains. Multilevel mixed effects logistic regression was used to assess associations between urbanicity and household food security (measured using the validated Household Food Insecurity Access Scale), and to investigate modifying effects of agricultural occupation.
RESULTS
Urbanicity scores ranged between 13 and 69, of a possible 80 points. Most agricultural households in the mountains (67%) and hills (54%) were categorized food insecure. Increases in urbanicity were negatively associated with food insecurity, controlling for other factors (odds ratio [OR] per 10-unit urbanicity difference OR: 0.82; confidence interval [CI]: 0.71, 0.94; ≤ 0.05). Agricultural occupation may have positively influenced this association though was not a statistically significant effect measure modifier ( = 0.07).
CONCLUSIONS
The novel scale shows more nuance within Nepal's agroecological zones, which had similar urbanicity-to-food security relationships as well as overlapping urbanicity score distributions. Research and policy efforts should consider using scales providing more precise urbanicity measurement, and thus informative assessments on its role in predicting food insecurity, especially in agriculturally reliant populations.
PubMed: 38948107
DOI: 10.1016/j.cdnut.2024.103773 -
Current Developments in Nutrition Jun 2024Produce prescription programs (PPPs) are place-based interventions at the intersection of public health and local food advocacy. These programs have expanded...
Produce prescription programs (PPPs) are place-based interventions at the intersection of public health and local food advocacy. These programs have expanded significantly across the United States since 2010, particularly taking off in the state of West Virginia. This article draws on a 4-y institutional ethnography of PPP programs and associated policy. Although the possibilities of building support for improving community health alongside the livelihoods of small-scale producers is compelling, there exists an overall decontextualization from broader social and political determinants of health. This article concludes that although programs are able to meet some acute needs for program participants and provide income for small-scale producers, this decontextualization results from a lack of consideration of wider systems within policy and program construction, leading to missed opportunities for food system transformation.
PubMed: 38948106
DOI: 10.1016/j.cdnut.2024.103775 -
International Journal of Public Health 2024We evaluated the long-term effects of air pollution controls on health and health inequity among Chinese >45 years of age.
OBJECTIVES
We evaluated the long-term effects of air pollution controls on health and health inequity among Chinese >45 years of age.
METHODS
Data were derived from the China Health Aging and Retirement Longitudinal Survey and the China National Environmental Monitoring Centre. Decreases in PM and PM were scaled to measure air quality controls. We used a quasi-experimental design to estimate the impact of air quality controls on self-reported health and health inequity. Health disparities were estimated using the concentration index and the horizontal index.
RESULTS
Air pollution controls significantly improved self-reported health by 20% (OR 1.20, 95% , 1.02-1.42). The poorest group had a 40% (OR 1.41, 95% , 0.96-2.08) higher probability of having excellent self-reported health after air pollution controls. A pro-rich health inequity was observed, and the horizontal index decreased after air pollution controls.
CONCLUSION
Air pollution controls have a long-term positive effect on health and health equity. The poorest population are the main beneficiaries of air pollution controls, which suggests policymakers should make efforts to reduce health inequity in air pollution controls.
Topics: Humans; Air Pollution; China; Male; Female; Middle Aged; Aged; Health Status Disparities; Longitudinal Studies; Particulate Matter; Socioeconomic Factors; Environmental Exposure; East Asian People
PubMed: 38948086
DOI: 10.3389/ijph.2024.1606956